The New York Clinical Information Exchange Planning Project will lead to the creation of a two-year IAIMS plan to establish a health information exchange system that will enable Emergency Department (ED) clinicians to access critical clinical information not otherwise available for patients who have been seen at other institutions within the Greater New York Region. The primary goal of this project is the improvement of patient safety and the reduction of adverse medical events in the ED patient population, an environment notable for critical information gaps and medical acuity. An additional goal is the improvement of efficiency of care through the reduction of unnecessary test and hospital admissions. The plan will include the technical, governance, financial, clinical, legal, and evaluation aspects of such an information exchange system, and will establish the first cooperative information exchange project among a number of leading healthcare entities in the region. Specific aims include: Aim 1) Develop an IAIMS plan to address a compelling need to provide ED clinicians with authoritative clinical data obtained from participating health care facilities to improve clinical care and patient safety. Aim 2) Establish a process to identify and prioritize other clinically and economically valuable information exchange opportunities within the community of participating organizations. This will include adding to the set of clinical data elements and expanding the scope of participating organizations both geographically within the Greater New York region, and across the health care continuum. Aim 3) Create an evaluation strategy to assess the clinical and economic value of ED-based information exchange. We believe that the IAIMS plan described herein will lead to the implementation of a pilot clinical information exchange system that will demonstrably improve emergent care within the Greater New York Region. In addition, this plan will lay the foundation for expanded information exchange encompassing other care venues and organizations.